RESUMO
Objective: The objective of this study focuses to unfold the importance of creatinine clearance in determining the gastrointestinal mani-festations and Helicobacter Pylori infection
Study Design: Cross-sectional comparative study
Place and Duration of Study: Medicine department of Fauji Foundation Hospital Rawalpindi, from Jun 2015 to Dec 2016
Material and Methods: Creatinine clearance of 73 CKD patients was calculated. UGI endoscopy was performed to detect gastro-intestinal lesions. H.pylori was detected by histopathology of gastric mucosal biopsy. The diagnostic accuracy of CCl in determining the presence of gastrointestinal [GI] lesions was determined by receiver operating characteristic [ROC] curve [AUC]. Cut-off value, sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios were obtained by Youden index
Results: Mean CCl was 27.09 +/- 12.16 ml/min. Diabetes mellitus was the top most cause of CKD [45.2 percent]. Upper GI endoscopic lesions were present in 68.5 percent patients [p-value<0.05]. The most common abnormality was erythematous gastritis. H. pylori infection was lower in disease group compared to controls, but statistically insignificant [p>0.05]. The AUC for CCl in determining the gastrointestinal lesions was 0.8 [p-value
Conclusion: CCl was found, noninvasive marker in predicting the GI abnormalities. It can be used to identify the high risk patients. Such patients then can undergo endoscopy for further management. H.pylori eradication therapy should be offered to those patients in whom its presence is proven by other tests as well
RESUMO
To analyze the influence of previous exposure to HBV on liver histology and treatment outcomes in chronic hepatitis C [CHC] patients. Case control study. Rawalian Liver Clinic, Department of Medicine, Holy Family Hospital, Rawalpindi, from January 2011 to December 2012. Medical records of CHC patients attending the Rawalian Liver Clinic were retrospectively analyzed. Virological and treatment responses along with histological changes were compared between cases [anti-HBc positive] and controls [anti-HBc negative]. Significance was determined through chi-square test at p < 0.05. Among the 592 CHC patients, 254 [42.9%] had serological evidence of a positive anti-HBc [cases] and 338 [57.1%], patients had negative anti-HBc [controls]. No significant difference was found between ETR, SVR and treatment responses [n=220] between the two groups. Out of 65 patients whose liver biopsy data was available, cases were more likely to respond in the absence of fibrosis [63.2%, [n=24] vs. 36.8%, [n=14], p=0.001]. The controls responded more in the presence of fibrosis [100% [n=9] vs. 0, p=0.001]. There was no significant effect of anti-HBc positivity on grades of inflammation and consequent treatment response [p=0.14]. There are a significant number of CHC patients with markers of previous HBV infection in Pakistani population. Previous HBV [anti-HBc positive] does not seem to have an adverse effect on liver histology and treatment responses in HBV infection